Healthcare Privacy and Anti-Fraud Act - Amends the Patient Protection and Affordable Care Act to require the Secretary of Health and Human Services (HHS) to issue guidance (including concerning liability) to protect the privacy of individually identifiable information submitted to, or accessed by, health care exchange navigators.
Requires entities receiving grants under the navigator program to ensure that their employees undergo background checks, take an oath not to disclose individually identifiable information, and meet educational and licensure requirements comparable to those applicable to health insurance agents and brokers in the state.
Imposes criminal penalties for disclosure of individually identifiable information and misrepresentation as a navigator.
Directs the Secretary to annually make available a list of entities providing navigator services and a list of those determined to be ineligible or convicted of offenses described in this Act.
Amends the Internal Revenue Code to exempt individuals from the penalty for not maintaining minimum essential coverage for any month if the failure resulted from advice of a navigator or a person purporting to provide such services.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1666 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 1666
To amend the Patient Protection and Affordable Care Act to improve the
patient navigator program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 7, 2013
Mr. Rubio (for himself, Mr. Boozman, Mr. Cochran, Mr. Inhofe, Mr.
McConnell, Mr. Roberts, and Mr. Flake) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Patient Protection and Affordable Care Act to improve the
patient navigator program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Healthcare Privacy and Anti-Fraud
Act''.
SEC. 2. TRAINING, BACKGROUND CHECKS, AND NONDISCLOSURE FOR PATIENT
NAVIGATORS.
(a) In General.--Section 1311(i) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18031(i)) is amended by adding at the
end the following:
``(7) Security and nondisclosure.--
``(A) Guidance by secretary.--Not later than 90
days after the date of enactment of this paragraph, the
Secretary shall issue guidance on the implementation of
this paragraph in order to protect the privacy of
individually identifiable information submitted to, or
accessed by, navigators under this subsection.
``(B) Background checks.--
``(i) In general.--An entity that receives
a grant under this subsection shall ensure that
universal background checks are conducted on
all employees of the entity prior to such
employees providing navigator services to
individuals, or prior to such employees having
access to individually identifiable information
as a result of providing such services. Such
background checks shall, at minimum, include a
criminal background check, fingerprinting, and
credit report.
``(ii) Limitation.--An individual who has
been found guilty of a felony, or guilty of a
misdemeanor involving deceit or dishonestly
(including identity theft, fraud, or perjury),
under Federal or State law shall not be
employed by an entity described in clause (i).
``(C) Oath.--
``(i) In general.--Prior to commencing
employment with an entity that receives a grant
under this subsection, an individual described
in clause (ii) shall have sworn or taken an
oath that he or she will not disclose any
individually identifiable information obtained
in the course of their employment (except
information relevant to the commission of a
felony when provided to an appropriate law
enforcement authority).
``(ii) Individual described.--An individual
is described in this clause if such individual
is being employed by an entity described in
clause (i) as a navigator, a non-navigator
assistant, or as an employee with access to
individually identifiable information.
``(D) Educational, training, and licensure
requirements.--Prior to conducting navigation services
for an entity under this subsection, an individual
shall meet educational and licensure requirements that
are identical or comparable to those currently
applicable to health insurance agents and brokers
within the State in which they seek to provide
navigation services, including the completion of at
least 30 hours of training (including training on
privacy rights under this Act and other relevant
Federal laws).
``(E) Liability.--Not later than 90 days after the
date of the enactment of this paragraph, the
Secretary--
``(i) shall issue guidance concerning how
liability and penalties will be applied by the
Secretary in instances of failure to comply
with requirements of this paragraph, including
where consumer outreach and enrollment
assistance causes harm to an individual as a
result of misuse or negligence in protection
and privacy of individually identifiable
information;
``(ii) shall determine whether such
liability lies with the navigator or non-
navigator assistance personnel involved or
whether liability lies with the entity that
received the grant under this subsection; and
``(iii) shall determine whether the
individuals or entities identified under clause
(ii) are required to obtain professional
liability coverage.
``(F) Penalties.--
``(i) In general.--Whoever having sworn or
taken the oath described under subparagraph
(C), publishes or communicates any individually
identifiable information which comes into his
or her possession by reason of his or her being
employed (or otherwise providing services)
under this subsection, shall be fined not more
than $5,000 or imprisoned not more than 5
years, or both.
``(ii) Misrepresentation.--Any person who
knowingly and falsely represents that such
person is, or holds himself or herself out as,
a navigator under this subsection shall be
fined not more than $5,000 or imprisoned not
more than 5 years, or both.
``(iii) Enhanced penalty for sale or
transfer.--A person who commits the offense
described under clause (i) with the intent to
sell, transfer, or use individually
identifiable information for commercial
advantage, personal gain, or malicious harm
shall be fined not more than $250,000,
imprisoned for not more than 10 years, or both.
``(G) Greater protections.--Nothing in
subparagraphs (A), (B), (C) or (D) shall be construed
to prohibit States from imposing additional standards
and protections to protect consumer information.
``(8) List of navigators.--Not later than 90 days after the
date of enactment of this paragraph, and annually thereafter,
the Secretary shall make available a list of entities providing
navigator services in accordance with this subsection and a
list of entities that have been determined to be ineligible to
provide such services or who have been convicted of a violation
under paragraph (7).''.
(b) Limitation on Liability.--Section 5000A(e) of the Internal
Revenue Code of 1986 is amended by adding at the end the following:
``(6) Reliance on navigator advice.--Any applicable
individual who for any month failed to obtain minimum essential
coverage as a result of the good faith reliance on the advice
of a patient navigator, counselor, or other employee of an
entity receiving a grant under section 1311(i) of the Patient
Protection and Affordable Care Act (or a person purporting to
be such a navigator, counselor, or other employee).''.
(c) Effective Date.--The amendment made by subsection (a) shall
take effect on the date of the enactment of this Act and shall apply to
grants made before, on, or after the date of the enactment of this Act.
The Secretary of Health and Human Services shall provide for the prompt
modification of such grants made before the date of the enactment of
this Act in order to comply with the requirement imposed by such
amendment.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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